CompFox AI Summary
The Workers' Compensation Appeals Board granted reconsideration and rescinded an order approving a Compromise and Release (C&R). The defendant argued for rescission based on a mutual mistake regarding the necessity of CMS approval for the Medicare Set Aside (MSA) amount. While CMS approval is not mandatory, the Board found the C&R inadequate as written. Specifically, the settlement did not adequately account for the MSA amount in relation to the applicant's net recovery, and the applicant was not fully advised of potential Medicare benefit denials if CMS review was bypassed. The case is returned for further proceedings to address these adequacy issues.
Full Decision Text1 Pages
The Workers' Compensation Appeals Board granted reconsideration and rescinded an order approving a Compromise and Release (C&R). The defendant argued for rescission based on a mutual mistake regarding the necessity of CMS approval for the Medicare Set Aside (MSA) amount. While CMS approval is not mandatory, the Board found the C&R inadequate as written. Specifically, the settlement did not adequately account for the MSA amount in relation to the applicant's net recovery, and the applicant was not fully advised of potential Medicare benefit denials if CMS review was bypassed. The case is returned for further proceedings to address these adequacy issues.
Read the full decision
Join + legal professionals. Create a free account to access the complete text of this decision and search our entire database.